24Drs好健康報:墮胎會造成長期的壓力？
好健康熱頭條 ─ 墮胎會造成長期的壓力？ Abortion Impact: Long-Term Stress?
好健康小單字─ 流產(Miscarriage)
好健康熱頭條 ─ 墮胎會造成長期的壓力？
流產與墮胎都是很有壓力的事情，但是挪威的研究指出，墮胎可能與長期的心理憂傷有關。
研究人員針對40位曾經流產、80位曾經墮胎的女性進行調查，並持續追蹤5年；曾經流產的女性在剛流產以及6個月後都會比較焦慮與憂鬱，但是墮胎的女性會在2年後，甚至5年後仍然很有壓力與焦慮。
研究人員Anne Nordal Broen醫師向WebMD表示，曾經流產的女性常在幾個月內會有心理創傷，常常會作惡夢並回想起來，但是在半年後，幾乎所有精神上的反應都會過去，將自己調適得很好。
【罪惡感與羞愧感比較強】
曾經墮胎的女性在剛開始問題較少，Broen醫師表示，她們的長期問題並未到達受創的地步，但是這些女性在做心理測驗時顯示，5年後感到罪惡感的人數比曾經流產的人數多兩倍，而且有60%的人比較會感到羞愧。
兩組在5年內都表示很少想起這些事情，但是曾經墮胎的女性表示，她們主動避免想起這些事情的次數，比曾經流產的女性多七倍。
當與一般人做比較時，曾經墮胎的女性在每次測試（從懷孕終止後10天至5年後）時，焦慮的分數都比較高；曾經流產的女性則只有在懷孕終止後10天時的測試中，顯示較高的焦慮分數。
研究結果刊載在12月號的BMC醫學（BMC Medicine）期刊中；Broen醫師表示，目前從研究中還不清楚是否是墮胎造成焦慮的分數較高，還是曾經墮胎的女性本來就會比較焦慮。
她表示，這些女性的精神健康不佳，這會讓她們比較容易受傷；但這也可能是因為她們不讓自己想起這些事情，並且調適這些想法，造成了她們的憂傷。
研究人員指出，在徵求加入實驗的女性時，只有一半受邀的女性願意，這兩組女性的婚姻狀況、小孩人數、以及工作等差異也值得注意，這些都會影響到研究結果。
【有關墮胎壓力的爭論】
有關墮胎對於情緒上的影響一直有爭議，主張墮胎合法化以及反對墮胎的兩方擁護者對於這個爭議一直都有很大的歧見；有些人辯稱，創傷後緊張是選擇墮胎的婦女常見的現象，但是美國心理學協會與美國精神病學協會都沒有正式的認可這種症狀。
加州大學舊金山分校的精神病學教授Nancy Adler博士有主導一部份墮胎對於心理影響的研究，她表示，沒有研究能夠確認這個問題的答案；她向WebMD表示，你是無法將不想懷孕的人強制分配為墮胎或是生產的，並不是對大多數不想懷孕的女性會有壓力的感覺予以否定，也不是要否定有關這件事的決定，但是他們並未看到臨床上長期創傷的證據。
耶魯大學精神學系教授Kimberly Yonkers醫師同意這個看法，她指出，研究中的兩組都顯示，經過一段時間後，在心理壓力測試上有所改進，她也對於研究規模太小表達關切，不過她表示，這個研究的一個優點是對於這些女性追蹤很久。
她指出，她並不認為需要對於自願終止懷孕的人還有罪惡感與羞愧感感到訝異，這並不是那種不會認真思考就去做的事，但她並不相信墮胎後的症狀，因為她沒有看過，而且她不認為這些數據在圖形或表格上代表某種程度的意義。
Abortion Impact: Long-Term Stress?
Miscarriage and abortion are both stressful events, but a study from Norway suggests that abortion may be associated with more long-term psychological distress.
Researchers interviewed 40 women who had miscarriages and 80 women who had abortions and followed them for five years.
Women who had miscarriages suffered more anxiety and depression immediately after the event and six months later. But abortion was associated with more stress and anxiety two years -- and even five years -- after the event.
"The women who had miscarriages were often psychologically traumatized for several months," researcher Anne Nordal Broen, MD, tells WebMD. "Nightmares and flashbacks were not uncommon, but within half a year most of these mental responses were over and they were managing well."
Guilt, Shame Greater
Women who had abortions had fewer problems early on, and Broen says their long-term issues did not approach the level of trauma. But these women were also twice as likely to feel guilt about the event five years later and 60% more likely to feel shame, as measured by psychological testing.
At five years, both groups had few intrusive thoughts about the event. But the women who had abortions were seven times as likely to report that they actively avoided thinking about it.
When compared with the general population, women who had abortions had higher anxiety scores at all measured time points -- from 10 days after the pregnancy termination to five years later. Women who had miscarriages had higher than normal anxiety scores at only one of the measured time points -- 10 days after their pregnancy ended.
The findings are published in the December issue of the journal BMC Medicine.
Broen says it is not clear from the study if having an abortion contributed to the higher anxiety scores or if the women who had abortions were more anxious to begin with.
"These women may have had poorer psychiatric health, which would make them more vulnerable," she says. "But it may also be that they didn't allow themselves to think about the event and deal with it, and that this contributed to their distress."
The researchers write that only about half of the women who were asked to be included in the study agreed to participate. There were also notable differences between the two groups of women regarding marital status, number of existing children, and employment, all of which could contribute to the their findings.
Debate Over Abortion Stress
The debate over the emotional impact of abortion is a contentious one, with pro-choice and anti-abortion advocates not surprisingly having very different views of the issue.
Some people contend that a form of posttraumatic stress is common among women who have had elective abortions. But neither the American Psychological Association nor the American Psychiatric Association officially recognizes such a syndrome.
University of California, San Francisco psychiatry professor Nancy Adler, PhD, conducted some of the first studies on the psychological impact of abortion. She says it would be impossible to do a study that definitively answered the question.
"You would have to assign women with unwanted pregnancies to either have an abortion or give birth, and that would never happen," she tells WebMD.
"There is no denying that the experience of unwanted pregnancy is very stressful for most women, and so is the decision about what to do about it. But we are not seeing evidence of long-term trauma at the clinical level."
Yale University psychiatry professor Kimberly Yonkers, MD, agrees. She points out that both groups in the study showed improvements over time in most measures of psychological stress. She also expressed concerns about the study's small sample size but said one of the study's strengths was that it followed the women for so long.
"I don't think it is much of a surprise that there was residual guilt and shame following the voluntary termination of a pregnancy," she says. "This is not the kind of thing that someone does and never thinks about again. But I don't believe in postabortion syndrome because I haven't seen it. And I don't think these data show it in any way, shape or form."
SOURCES: Broen, A.N. BMC Medicine, Dec. 12, 2005; vol 3; online edition. Anne Nordal Broen, MD, University of Oslo, Oslo, Norway. Nancy Adler, PhD, professor and vice chairwoman, psychiatry, University of California, San Francisco. Kimberly Yonkers, MD, associate professor, department of psychiatry, Yale School of Medicine, New Haven, Conn.
WebMD Medical News
by Salynn Boyles
Reviewed By Louise Chang
好健康小單字─ 流產(Miscarriage)
「流產」俗稱小產，是指胎兒能存活前，懷孕即已終止，一般是妊娠20週前，或胎兒體重低於500公克；發生在妊娠12週以內的流產為早期流產，發生在妊娠12~28週的流產為晚期流產；流產的主要表現是陰道流血和下腹部疼痛。
想看更多好健康的資訊嗎? 請上24Drs國際厚生
留言列表
{{ article.title }}
